Friday, August 27, 2010

I'm home! I've got six whole days off to enjoy the Minnesota State Fair, spend time with Chris and Winnie, see as many friends and family members as possible, and celebrate our one year wedding anniversary. So, no veterinary education for the next few days, but I'm sure there will be lots of pictures to share!

Here's a nice fair photo to start off with:

... and one from my walk with Winnie this morning. So nice to spend time with my puppy!

Wednesday, August 25, 2010

Blogger/Google has been updating the look and tech of blogger so I thought we should too. And since Megan has been blogging so much, I need to too! Here are just a few things that I am going to write about soon:

Monday, August 23, 2010

Well, I do get some time off, after all, so here's what I learned today...

Thanks to Netflix, I've been watching The Office for the first time. The subtlety of some of the humor never ceases to amaze me. For example, in season 5, there are three episodes in which there is a second office featured (I won't describe why, to avoid giving away spoilers...). The second office contains a goldfish in a bowl. But note, in each episode, there is a different goldfish- one calico, one black, and one gold:

Sunday, August 22, 2010

After having a couple of rotations on emergency overnights and spending some time with urgent care on days, I'm starting to get a good sense of situations when owners should get their pets in ASAP. Sometimes it's safe to wait for a day or two to see if things resolve on their own, but sometimes there just isn't time to wait. For example:

The dog/cat/ferret/etc ingested something potentially toxic, like chocolate, rat poison, ibuprofen, Tylenol, or an entire bottle of Rimadyl chew tabs. Especially in cases where there is known ingestion, pets should always be seen as soon as possible to have vomiting induced. Some people think it's better to wait and see if their pet starts showing clinic signs of toxicity, like vomiting, not acting right, etc, but some toxins can take days or weeks to show their full effects. Rat poison can cause bleeding into body cavities that wouldn't be noticed by the owner until the pet is severely anemic. Ingestion of Tylenol can cause irreversible liver damage that might not make a pet clinically ill for several days. It's always better to get the toxin out by induction of vomiting and try to absorb as much of the remaining toxin by administration of activated charcoal than it is to take a "wait and see" approach.

The pet is seizuring. I'm not sure why owners seem to panic over vomiting and diarrhea but don't seem to be as concerned by seeing their pet have a seizure. We get a lot of phone calls asking if a seizuring pet should be seen right away. Seizures that end quickly generally don't cause much damage (aside from making the pet disoriented/distressed and possibly injuring themselves by falling into or off of furniture, or biting their own tongue). Seizures that are prolonged can cause significant brain damage and other organ damage as the body because hyperthermic. There is no way to know if a seizure is going to be a solitary event or if it will become a pattern. Observation at a clinic is important so that, if your pet begins seizuring again, the seizures can be stopped immediately. There are a lot of underlying causes for seizures, so a thorough exam is important to try to determine why the pet started seizuring in the first place.

Cats who can't urinate. Oftentimes, owners mistakenly think that a cat who is straining in the litterbox is "constipated", when in reality, they are straining to urinate. Cats- especially male cats- can develop blockages in their urethra that completely obstruct the flow of urine. Their bladders can fill to the point that they ultimately die of severe electrolyte abnormalities or bladder rupture. A typical (unfortunate) scenario is that an owner sees their cat straining in the litter box in the morning, leaves for work, and comes home to find a dead cat. Urethral blockage is extremely painful and should be addressed immediately.

Multiple episodes of vomiting in a short period of time, vomiting blood, projectile vomiting, or unproductive retching. Little stomach bugs or a single episode of dumpster diving cause vomiting, but typically not vomiting with the above signs. When we see these signs, we start to worry about problems like foreign body ingestion, gastric ulceration, parvovirus infection in puppies, or GDV (especially in large, deep-chested breeds). This is not "wait and see" sort of vomiting- vet examination ASAP is indicated.

Exotic pets acting abnormal in any way. Aside from ferrets, almost all exotic species are prey animals that are hard-wired to never show signs of disease or injury. If these animals go off of food, start sleeping more than normal, stop vocalizing (if it's a bird), start vocalizing (if it's a small mammal), hide when they would normally be active, or do anything out of the ordinary, it could well be a sign of disease. Often, by the time you can obviously tell there is something wrong, exotic species are severely compromised. Better safe than sorry with exotics!

Pets who have been hit by a car or attacked by another animal. Even if it doesn't look like there are any injuries, many severe internal injuries don't make themselves known right away. Splenic rupture, bladder rupture, or penetrating wounds into the chest are all examples of wounds that a pet owner might not notice, but that could ultimately become fatal. Cats in particular are masters at hiding severe injuries until they decompensate. Don't wait until pets show signs of injury after major trauma- have them evaluated as soon as possible to give them the best shot at treatment and recovery in case there are some hidden injuries.

In general, pet owners should ask themselves what they would do if this same scenario were happening to their baby or toddler. Pets, like young children, can't tell us what's wrong or where it hurts, so a physical exam by a doctor is really important in cases of injury or illness. Early intervention is almost always better than playing the "wait and see" game, and it's certainly cheaper to catch a disease or injury early on when it can be treated on an outpatient basis than to wait until the pet needs to be hospitalized.

Thursday, August 19, 2010

OCD could stand for Obsessive Compulsive Disorder (which pets can suffer from), but today it stood for Osteochondrosis (or Osteochondritis Dissecans). OCD is a developmental orthopedic disease that typically causes lameness in puppies 7 to 12 months old, and most commonly affects the shoulder, elbow, stifle, or hock joints. OCD occurs when part of the smooth cartilage that lines the joint surface doesn't form correctly, resulting in a defect in what should be a nice smooth joint surface. The joint ends up arthritic and painful, leading to limping in puppies that should be bouncing off the walls.

In the case today, we saw a 9 month old female Goldendoodle with forelimb lameness. She was painful on manipulation of her shoulder joint, and her radiographs showed the typical abnormalities associated with shoulder OCD. Unfortunately for her, the options for treatment are either surgical removal of the abnormal cartilage or long-term medical management for arthritis. And while dogs usually return to full function after surgery, the joint usually (eventually) goes on to develop arthritis anyway. And the disease is very commonly bilateral, which means her other shoulder will probably become sore soon and require the same sort of intervention.

This is a major financial burden for a pet owner who thought the most expensive surgery her pet would be facing is her spay. It's also disappointing for the owner, who thought her pet might make a competitive agility dog. She also thought that getting a "mixed breed" dog would lessen the likelihood of congenital disorders... but unfortunately, Doodles are just as prone to the developmental disorders of Goldens as are purebreds, and they're also prone to the developmental disorders of standard poodles.

So, today I learned:

it stinks to tell a pet owner that their animal has a limp that won't go away on its own, that requires surgery to correct, and that will give the pet lifelong predisposition to developing arthritis

it stinks to see a happy bouncy puppy walking with a painful limp

it can be hard to convince an owner that, despite being happy and bouncy, your puppy is in pain (otherwise, why would she be limping?)

Hmm. I've been stuck in a blogging funk lately, writing posts that sound a little too negative to actually publish... I don't want to turn this blog into a spot to vent, but I hate to let it sit idle too!

So, here's my goal for the next month: one post a day about something I've learned- about medicine, or surgery, or Tucson, or communication skills, or whatever. An internship isn't valuable if you don't take time to reflect on it. So, here goes day 1:Feline malocclusions. A fancy way to say that the teeth aren't lined up right, malocclusions are much more common in dogs than cats because dogs' heads come in a much wider variety of shapes and sizes. The photo to the left is a canine (dog) canine (tooth) malocclusion, in which the lower tooth is contacting the upper hard palate, causing damage to the tissue. Despite being more common in dogs, cats do indeed get malocclusions, and I learned that thanks to my own kitty, Taiko.

Taiko turns 7 months old tomorrow (happy birthday kitten!), and so just finished getting his adult teeth in. I was trying to be a good cat mom and start brushing his teeth early, so that we get used to the routine. A couple of weeks ago, I was brushing and noticed that his breath smelled extremely foul. A 6 month old kitten should NOT have stinky breath (of course, neither should older cats- halitosis is a sign of dental disease as well as many other diseases). I examined his mouth a little closer and discovered that he had a malocclusion of his fourth premolars (teeth #108 and #208, for you Triadan folk). They were set too narrow, so the sharp points of his premolars were digging painful pits into the soft tissue and gingiva of his lower jaw. The foul smell was the infection setting into the gingival tissue. Taiko had both of his 4th premolars extracted and had x-rays taken of his lower first molars to assess the damage caused by the malocclusion. While he had some damage to the gingiva and some horizontal bone loss, he was able to keep his lower molars for now- hopefully we stopped the damage early enough that the integrity of the molars wasn't too compromised. In some specialty dental centers, the sharp points of the 4th premolars can be smoothed down and the teeth can be spared, depending on the severity of the malocclusion. In dogs, some malocclusions can be corrected with orthodontics (yes, seriously).

So, lessons learned:

Always check the occlusion of teeth in puppies and kittens- even babies can have dental disease